contribution funding framework and health planning process
DESCRIPTION
Contribution Funding Framework and Health Planning Process. May 2007 FNIH, BC Region. Presentation Overview. Introduction to the new Health Funding Arrangements (HFA) Clustering – the new FNIHB Program Authority Structure Details of the new HFA Health Planning Process - PowerPoint PPT PresentationTRANSCRIPT
Contribution Funding Framework and Health Planning Process
May 2007
FNIH, BC Region
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Presentation Overview Introduction to the new Health Funding
Arrangements (HFA) Clustering – the new FNIHB Program
Authority Structure Details of the new HFA Health Planning Process Timelines and Transitioning
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Introduction: Goals of New HFA Increase First Nations control over design and
implementation of health programs Focus on health planning process Increase community capacity Streamline reporting Support communities to incrementally increase the
number of programs they design/deliver Create plans for health that are tailored to the needs
of communities Support long-term planning and stable funding
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Introduction: Sources of Input into new HFA
Auditor General Reports on Horizontality, Grants and Contributions
Accountability Act Treasury Board Review/Directive of Aboriginal
Transfer Payments National Evaluation Report on Transfer Lessons learned from Health Plan Demonstration
Projects
ClusteringUpdated FNIHB Program Authority Structure
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ClusteringGOALS Linking programs that are similar to “break down the
silos” Promoting holistic, integrated health planning Streamlines financial and program reporting (cluster-
based reporting templates)
The cluster model also has impacts on the flexibilities possible under the new HFA
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FNIHB Program Authority Structure
Community Programs
Health ProtectionHealth
Benefits
Children & YouthMental Health &
Addictions
Chronic Disease & Injury
Prevention
Communicable
Disease Control
Environmental Health &
Research
Primary Health Care
AUTHORITY
COMPONENTS
(Clusters)
PROGRAMS & ACTIVITIES
• Aboriginal Head Start On- Reserve
(AHSOR )• Canada Prenatal
Nutrition Program(CPNP ) – FN/ Icomponent
• Fetal Alcohol Spectrum
Disorder (FASD )• Maternal& Child
Health
• Building Health Communities(BHC)
• Brighter Futures(BF )• National Native Alcohol& Drug Abuse -
Residential Treatment(NNADAP -res)
• National Native Alcohol& Drug Abuse(NNADAP )
• Youth Solvent Abuse Program(YSAP )
• FN/ I Tobacco Control Strategy(TCS )
• Indian ResidentialSchools
• Labrador Innu Comprehensive
Healing Strategy• National Youth Suicide
Prevention Stradegy
• Aboriginal Diabetes Initiative(ADI)
• Nutrition& Physical Activity Promotion
(NPAP )• Injury Prevention(IP )
• Vaccine Preventable
Disease(Immunization) Programs
• Blood Borne Disease and Sexually
Transmitted Infections
(HIV /AIDS)• Respiratory
Infections(Tuberculosis)
Programs
• Environmental Health Programs
• Environmental Health Research
Programs
• Community Primary Health
Care (PHC )• Oral Health
Strategy (OHS )• FN/ I Home&
Community Care(HCC )
• NIHB• NIHB NWT
First Nations& Inuit Health Branch
HealthGovernance /
InfrastructureSupport
• Health Planning& Management
• Health Consultation& Liaison
• Integration& Adaptation of Health
Services• Management&
Delivery of HospitalServices
• Security Services• Health HumanResources
• Support Services forNursing
• Health Research• e-Solutions• FN / I Health Careers
Capital
• Health Facilities and
Capital
December2006
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Sample of Cluster: Mental Health And Addictions
The Program Authority is: Community Programs
The Component (Program Cluster) is: Mental Health and Addictions
The current programs and services include: Brighter Futures, Building Healthy Communities (Mental Health and Solvent Abuse), NNADAP
New Health Funding ArrangementsDetails on the new HFA
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New Health Funding Arrangements
Health planning is based on an assessment of community capacity and readiness Governance, Administrative and Service Delivery
Increased flexibilities Financial Reporting (streamlined, and according to clusters) Harmonizing across departments (internally and
externally) Communities can incrementally assume more
responsibilities as their capacity increases Collaborative partnership between communities and
FNIH
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Funding Arrangements
PREVIOUSLY Three defined stages of Agreement to move through, and many elements
(e.g. community size) determine whether the community may proceed to the final phase General Integrated Transfer
NEW HEALTH FUNDING ARRANGEMENTS Single funding agreement with various funding models based on
community capacity and readiness Set Transitional Flexible Flexible Transfer
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Description Set Funding Model
Recipient establishes a multi-year Program Plan, based on terms and conditions for programs identified in the schedules of the agreement
Agreement is up to 3 years in duration Mandatory programs usually provided by FNIHB:
Communicable Disease Control Environmental Health Treatment Services (if applicable)
Funds may be redirected among activities within single components (or clusters) upon obtaining written approval of the Minister
Recipient provides interim and annual reports according to national templates
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Description Transitional Funding Model
Recipient establishes a Multi-Year Work Plan to guide program delivery
Agreement is 2-5 years in duration (generally 3-5 years to support long-term planning
Mandatory programs may be provided in combination with FNIHB
Funds can be redirected among components (or clusters) within authorities upon obtaining written approval of the Minister
Ability to carry forward funds to the next fiscal year with plan and approval
Recipient reports include annual financial audit, annual national reporting templates, and indicators identified in Multi-Year Work Plan
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DescriptionFlexible Funding Model
Recipient establishes a Health Plan to guide program development and delivery
Agreement is 5 years in duration Recipient delivers mandatory programs as applicable Funds can be redirected across authorities according to
priorities identified in the Health Plan Recipient able to retain surplus for reinvestment in health
priorities indicated in the Health Plan Recipient reports according to annual financial audits, annual
national reporting templates, indicators identified in Health Plan and completes an evaluation every 5 years
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DescriptionFlexible Transfer Funding Model
Recipient must deliver all mandatory programs In addition to the provisions under the flexible funding
model, this model allows for: The ability to foster integration initiatives with flexible
approaches and inter-governmental arrangements Professional advisory functions Program advisory functions Redesign of non-mandatory programs
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Funding Models Financial Reallocation Flexibilities
Community Programs
Health ProtectionHealth
Benefits
Children & YouthMental Health &
Addictions
Chronic Disease & Injury
Prevention
Communicable
Disease Control
Environmental Health &
Research
Primary Health Care
AUTHORITY
COMPONENTS
(Clusters)
PROGRAMS & ACTIVITIES
• Aboriginal Head Start On- Reserve
(AHSOR )• Canada Prenatal
Nutrition Program(CPNP ) – FN/ Icomponent
• Fetal Alcohol Spectrum
Disorder (FASD )• Maternal& Child
Health
• Building Health Communities(BHC)
• Brighter Futures(BF )• National Native Alcohol& Drug Abuse -
Residential Treatment(NNADAP -res)
• National Native Alcohol& Drug Abuse(NNADAP )
• Youth Solvent Abuse Program(YSAP )
• FN/ I Tobacco Control Strategy(TCS )
• Indian ResidentialSchools
• Labrador Innu Comprehensive
Healing Strategy• National Youth Suicide
Prevention Stradegy
• Aboriginal Diabetes Initiative(ADI)
• Nutrition& Physical Activity Promotion
(NPAP )• Injury Prevention(IP )
• Vaccine Preventable
Disease(Immunization) Programs
• Blood Borne Disease and Sexually
Transmitted Infections
(HIV /AIDS)• Respiratory
Infections(Tuberculosis)
Programs
• Environmental Health Programs
• Environmental Health Research
Programs
• Community Primary Health
Care (PHC )• Oral Health
Strategy (OHS )• FN/ I Home&
Community Care(HCC )
• NIHB• NIHB NWT
First Nations& Inuit Health Branch
HealthGovernance /
InfrastructureSupport
• Health Planning& Management
• Health Consultation& Liaison
• Integration& Adaptation of Health
Services• Management&
Delivery of HospitalServices
• Security Services• Health HumanResources
• Support Services forNursing
• Health Research• e-Solutions• FN / I Health Careers
Capital
• Health Facilities and
Capital
December2006
S E T S E T S E T S E T S E T S E T S E T S E T S E T
TRANSITIONAL TRANSITIONAL
FLEXIBLE / FLEXIBLE TRANSFER
Note: NIHB and Indian Residential Schools will always remain in the Set funding model
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Funding Model Comparison
Set Transitional Flexible Flexible Transfer
Recipient establishes multi-year program plan
Recipient establishes multi-year work plan including a health management structure
Recipient establishes a health plan including a health management structure
In addition to the Flexible model, this model allows for: The ability to foster integration initiatives with flexible approaches and inter-governmental arrangements Professional advisory functions Program advisory functions Redesign of non-mandatory programs
Recipients only able to reallocate funds within the same component (program cluster), on written approval by the Minister within the fiscal year reporting period
Recipients able to reallocate funds in the same Program Authority with approval
Recipients able to reallocate funds across authorities (with the exception of specifically identified programs)
Duration up to 3 years Duration 2 to 5 years * Duration 5 years Duration 5 to 10 years
Interim and final (year end) financial reports;
Non-Insured Health Benefits Program requires a minimum of three reports
Annual year end audit report Annual year end audit report
Annual report as per cluster performance indicators;
Non-Insured Health Benefits Program requires a minimum of three reports
Annual report as per program cluster performance indicators
Annual report to recipient’s members and to the Minister based on
annual reporting guide
No Evaluation Report No Evaluation Report Evaluation Report every 5 years
No retention of surplus and no carry forward of funds into the next fiscal year
Recipient, with the approval of the Minister, is able to carry forward program funding for reinvestment in the following fiscal year within the same Program Authority
Recipients able to retain surpluses to reinvest in health priorities
ALL MANDATORY PROGRAMS MUST BE DELIVERED
*Transitional agreements usually run for 3 – 5 years to support long term planning needs at the community level
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Planning & Reporting Requirements
Planning Requirements
(beginning of each year of Agreement)
Set
Funding Model
Transitional Funding Model
Flexible Funding Model
Flexible Transfer Model
Program Plan
(Annual & multi-year)
√
Multi-Year Work Plan √
Health Plan √ √
Reporting Requirements
Annual Year End Auditor’s Report √ √ √
Report on Health Program Expenditures √
Statement of Moveable Asset Reserve √ √
Report on the Provision of Mandatory Programs
√ √ √ √
Annual Report on Programs √ √
Annual Report to Recipient Members and to the Minister
√ √
Evaluation Report every 5 years √ √
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Recipient Reporting Schedule
Funding Model Financial Reporting Program Reporting Plans
Set One interim and one final report due July 29th *
Annual Report as per Annual Reporting Requirements due July 29th *
Multi-Year Program Plan before commencement of agreement and updated as required
Transitional Annual Audit Report as per Auditing and Reporting Requirements due July 29th
Annual Report as per Annual Reporting Requirements due July 29th
Multi-year Work Plan - before commencement of agreement, updated as required
Flexible, and
Flexible Transfer
Annual Audit Report as per Auditing and Reporting Requirements due July 29th
Annual Report as per Annual Reporting Requirements due July 29th
Health Plan- before commencement of agreement, updated as required
Where there is a single contribution agreement consisting of multiple funding models, the Annual Program Report and Annual Audit Report are due within 120 days after the end of the fiscal year.
The Non-Insured Health Benefits and Indian Residential Schools programs can only be funded through a SET funding model
Health Planning ProcessUpdated process to reflect new HFA
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Health Planning Process
Assessment
Health Plan
Multi -Year Program Plan
Multi -Year Work Plan
Flexible TransferModel
Flexible Model
Transitional Model
Set Model
Single Agreement
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Health Planning Process
Timeline of approximately 2.5 years from start to finish
Increased involvement of regional program managers in health planning and review
Work Plans and Health Plans must be reviewed by HQ
The number and specific communities in BC chosen to begin the process will depend on interest, capacity assessments, and regional capacity
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Health Planning ProcessHealth Plan
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Health Planning Process Multi-Year Work Plan
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Health Planning Tools
FNIHB Contribution Funding Framework – Overview FNIHB Contribution Funding Framework - User Manual Developing and Implementing a Health Plan – A Guide Health Planning and Implementation Summary Chart Assessing a Health Plan – A Regional Guide A Guide to Preparing a Multi-Year Work Plan Strengths First – a Guide on Asset Mapping Emergency Preparedness Planning – Sample Guide Regional Routing Slip – Health Plan Review (sample form) Presentation: CFF and HP Process (with speaker notes) FNIHB Program Authority Structure Chart Timelines for National Implementation of the New Funding Models Contribution Funding Framework – What’s Different? Questions & Answers – Contribution Funding Framework
Timelines and TransitioningHow BC Region intends to move forward
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Timelines
2007/2008 2008/2009
Orientation and Training for regional staff and community health staff/leadership on cluster-based reporting and new health funding arrangements
Finalization of guidelines, tools, agreement schedules, and national cluster-based reporting template
Begin health planning with communities wishing to transition into new funding arrangements, according to interest, community capacity assessments and regional capacity
All new agreements will include cluster-based reporting through the national template
All General agreements will become Set agreements
Phase in the implementation of agreements using the new health funding arrangements based on approved work/health plans
Communities may move to 3 year agreements
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Transition Process
The new health planning process has already started with demonstration projects
The existing agreements and new HFA will run concurrently for a period of time
Transition to the new process will be based on capacity and desire of First Nations, as well as regional capacity to engage in the health planning process
All agreements will transition to the new HFA within the next 4 years
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The Recipients Continuum of Control
LOW
Low CostNon -Complex Activities
Single AgreementShorter Term Agreements
Greater Simplicity & Flexibility
Results-basedMore Rigorous Risk Assesssment
Improved AccountabilityTransparent
Fosters Horizontality
More Upfront due DiligenceStreamline Reporting
HIGH
High CostComplex Activities
Single Multi -Party Agreement
Longer Term Agreements
Direct FNIHB delivery of service
Set Funding Model
Transitional Funding Model
Flexible Funding Model
Flexible TransferFunding Model
Self Government
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Questions? Contact your program officer: